Med Princ Pract. 2026 Apr 2:1-18. doi: 10.1159/000551819. Online ahead of print.
ABSTRACT
BACKGROUND: Chronic lymphocytic leukemia (CLL) is often complicated by comorbidities that may influence survival. In Kuwait, where cardiometabolic diseases are highly prevalent, a better understanding of their impact in CLL patients is essential. This study aimed to assess the prevalence and prognostic significance of comorbidities, particularly diabetes mellitus and vascular disease, in a Kuwaiti CLL cohort.
METHODS: We conducted a retrospective cohort study of 316 CLL patients at the Kuwait Cancer Control Centre between 2008 and 2021. Information on demographics, clinical details, and comorbidities was gathered from patient medical records. Overall survival (OS) was analyzed using Kaplan-Meier curves and Cox proportional hazards models; hazard ratios (HR) and 95% confidence intervals (CI) were reported.
RESULTS: The mean age at diagnosis was 60 years (SD 13), with a male-to-female ratio of 3:1. Hypertension (44%), diabetes mellitus (42%), and dyslipidemia (10%) were the most common comorbidities. Vascular disease was present in 6% and was strongly associated with inferior OS (adjusted HR 2.96; 95% CI 1.41-6.21; p = 0.004). Diabetes was also associated with increased mortality (HR 1.74; p = 0.034), though the association was weakened in multivariable analysis. IGHV mutational status was available for 61% of patients; unmutated IGHV was significantly associated with worse survival (p < 0.001).
CONCLUSION: Comorbidities, particularly vascular disease and diabetes mellitus , significantly affect survival outcomes in CLL patients. These findings highlight the importance of integrated management strategies that address both CLL and comorbid conditions, especially in populations with high cardiometabolic risk.
PMID:41926535 | DOI:10.1159/000551819